Healthcare Provider Details

I. General information

NPI: 1770566606
Provider Name (Legal Business Name): IVICA ZALUD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 PUNAHOU ST STE 540
HONOLULU HI
96826-1001
US

IV. Provider business mailing address

1319 PUNAHOU ST STE 540
HONOLULU HI
96826-1001
US

V. Phone/Fax

Practice location:
  • Phone: 808-983-6559
  • Fax: 808-983-6081
Mailing address:
  • Phone: 808-983-6559
  • Fax: 808-983-6081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number11043
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: